Latest / The Strategy Catalyst Dispatch / The Strategist in Brief: October 24, 2024

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The Strategist in Brief: October 24, 2024 · The Strategy Catalyst Dispatch

• 0:00
  This is the audio version of the strategist and brief.
• 0:06
  For this week's key market dive, we held an interview.
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  With cone health CSO, Chris Carnew to discuss the system's decision to join Ryzen.
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  And health.
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  Cone health long-term strategy involves a significant shift.
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  Shift into value based care and they believe joining Ryzen will accelerate that process.
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  Yes.
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  Ryzen is looking for health system partners with demonstrated expertise.
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  With value based care and a strong financial position for future growth.
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  Cone.
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  strategy and market was attractive.
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  A major point of differentiate.
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  for cone is its pluralistic physician model and strong connections.
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  With both employed and affiliated providers.
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  To generate buy-in.
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  This system brought together employed and affiliated physicians from 14 specialties.
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  Primary care.
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  OB GYN, GI oncology.
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  Cardiovascular hospitalist, pulmonary to.
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  Evaluate the Ryzen model from a clinical perspective.
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  They ended up becoming.
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  Coming major ambassadors to support the deal amongst the medical groups.
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  Cone health has hoping to shape horizons model and governance by becoming one of the earliest systems that joined.
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  The organization.
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  It will join councils to co-create Ryzen and its.
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  Model.
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  Cornu calls the deal, the most unique strategic partnership that I've ever seen in.
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  And now our first market scan.
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  Humana and Cigna have resumed merger talks and some analysts now think the deal.
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  Is a matter of, if not, when.
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  The deal was stalled due to the math.
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  Before, but Humana's declining value could make it possible.
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  The.
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  Combined entity would be the second largest payer by overall market share.
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  Hello.
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  Health systems might face tougher decisions around contracting, especially dropping.
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  Medicare advantage if Humana's ma contracts are attached to Cigna's commercial.
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  Marshall lives.
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  With that said Humana has been through this dance several.
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  Several times.
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  So there's healthy skepticism about the chances of success.
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  And regulatory approval.
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  Okay, moving onto our next market scan.
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  CMS released its M a quality star ratings for 2025.
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  Overall.
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  Overall the sheriff beneficiaries enrolled in plans.
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  Earning four plus stars fell.
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  Well from 74% in 2024 to 62% in 2025.
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  With particularly steep declines for United health group and Humana.
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  Only seven plans are now rated five stars.
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  The.
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  The shifting ratings could influence enrollment choices at a critical period as the peak of.
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  The baby boomer generation enters Medicare.
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  Health systems.
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  With their own provider, sponsored plans have an opportunity to differentiate themselves with higher.
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  Quality ratings while all systems may see opportunities to get quality bonuses.
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  Onuses or shared savings by including stars improvement efforts in contracts.
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  It's.
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  Following the success of similar suits last year.
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  United.
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  At health group and Humana are suing CMS over the declines, which could eventually scramble rating.
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  Our final market scan looks at recent negative headlines.
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  Lines in the world of retail pharmacy.
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  CVS announced that CEO.
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  Karen Lynch has stepped down from her position and is being replaced by David joiner.
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  Owner who currently leads Caremark.
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  The new CEO is a sign that the PBM.
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  BM and high margin business units are now the priority at CVS.
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  Lynch.
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  I had a vision for a broader flywheel, but was ousted for an inability to execute.
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  Cute on it.
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  The company is also cutting some infusion services handled by its.
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  It's corium subsidiary.
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  Hi, labor costs, low reimbursement.
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  Rates and competition from PE backed freestanding infusion centers.
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  It makes it exceedingly difficult for a non-hospital infusion business, like Corum to succeed.
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  Instead Corum we'll focus on higher margin specialty pharmacy.
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  The infusions.
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  Health systems have an opportunity to capture more of.
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  The growing alternative and home infusion segment and themselves.
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  Walgreens announced that their healthcare services arm saw losses in 2020.
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  For eight times larger than the previous year.
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  It plans to close 1200.
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  Stores over the next three years, including 500 within the next year.
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  The company's stock price rose on the news, a sign that investors think the retailer.
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  Retailers cost cutting efforts are credible.
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  Village MD is.
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  Now being viewed as a non-strategic asset, that Walgreens needs to monetize as the company.
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  That concludes our summary of this week.
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  Strategist.
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  Edition.
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  Be sure to check out the full version on the web@hmacademy.com.